Why does the left testicle hurt and what to do?

The left testicle hurts - men often turn to a urologist with such a complaint, experiencing a real panic, since the pain symptom is strong enough, and the reason for it has no objective, visible reason.

The testicles are small organs that should be evenly located in the scrotum on both sides. The upper part of each testicle has a cord, which, in turn, is rather complex in structure — it has arteries, veins, and the spermatic cord. Each testicle encircles the appendages, which are connected at the bottom, moving into the vas deferens. The testicles are responsible for the development of an important male hormone - testosterone, and also contribute to the development of spermatozoa, without which the process of reproduction and fertilization is impossible.[1]

Why does the left testicle hurt?

Pain in the testicles can manifest itself in the representatives of the stronger sex at any age - from child to old. When the left testicle hurts, the cause of such symptoms can be chronic prostatitis, which is manifested for the first time in this way, and sexually transmitted diseases - STDs, and trauma, and orchitis - an inflammatory process as complications after a venereal or infectious disease, and epididymitis - an inflammatory process in the scrotum caused by bacteria or gonococci. 

There are frequent cases when the pain in the left side increases and turns into a sharp, intolerable, which may indicate testicular torsion. This is not a pathology, but a physiological feature, rather rare, when the left testicle changes its position and blocks the blood flow going through the vessels into the scrotum. Such a shift is not an independent disease, however, it requires immediate assistance, since the testicle can atrophy without blood supply.

If the left testicle hurts - this is a clear sign of a violation of the structure of the scrotum organs, or a symptom indicating a pathological process inside the scrotum. The most common causes of such pain, which are found in clinical urological practice, are the following:[2]

• Injury (contusion, blow) testicle; 
• Inflammation of the testicle caused by urological infection, inflammation of the appendages, seminal vessels; 
• Underwear that squeezes the testicle; 
• Thermal effect, severe hypothermia; 
• The lack of a regular intimate life; 
• Twisting of the seminal canals, testicular torsion; [3]
• Cyst of the spermatic canal, cyst of the epididymis (or both testicles); 
• Varicose veins of the adjacent vein or varices of the spermatic cord - varicocele; 
• Tumor of the scrotum - a tumor of the testicles or their appendages, a tumor of the seminal canal; 
• Hernia in the groin ;[4]
• Dropsy, an increase in serous fluid between the lamina of the testicle - hydrocele; 
• Cancer pathology, cancer. Oncoprocess in the testes, seed vessels, appendages;  [5]
• Disturbance of nerve conduction as a result of injury to the lumbar, sacrum, or tailbone.
• Chronic orhialgia (chronic pain in the scrotum). [6]

The left testicle hurts most often as a result of the inflammatory process in the appendages. An appendage or epididymis is an important organ that ensures the development and motor activity of spermatozoa. It is the paired organ that surrounds the testicle, starting at the rear, ending at its surface.

Epididymitis is an inflammatory process in the epididymis of the left or right testicle, which is characterized by an increase in the size of the epididymis. When enlarged, the epididymis provokes painful sensations in the groin, as the appendage engulfs the testicle, then pain arises in it.[7]

Differential diagnostics

Radionuclide scans in patients can diagnose acute and chronic persistent pain in the testicles, including:

• testicular torsion (negative predictive value from 96 to 100%; positive predictive value of 75%). False positives (“cold” scans) can be caused by hydrocele, hematomas and hernias with trapped intestines;
• testicle abscess;
• testicular rupture or torsion from injury;
• epididymo-orchitis (hot scan);
• distinguish testicular torsion from testicular abscess.

Also, evaluate the testicle in patients with normal physical examination and associated emotional problems. When radionuclide scanning may be no damage in size from 1 to 1.5 cm

Modern ultrasound studies have better resolution and can detect lesions smaller than 1 to 1.5 cm. Thus, radionuclide angiography can reveal cases of torsion (cold scan) or epididymo-orchitis (hot scan). Hydrocele, hematoma, or hernia can cause a decrease in isotope absorption and mimic testicular torsion.[8]

If your left testicle hurts, when do you need to see a urologist?

Ideally, for any pain in the groin, whether it is the scrotum or the penis, or the crotch area, you should go to the urologist. Especially disturbing signs, not only when the left testicle hurts, the following are considered:[9]

• Pain on touching the testicles, both left and right; 
• Enlarged left or right testicle; 
• Changes in the shape of the left or right testicle; 
• The change in touch to the structure of the testicle, when it seems softer than usual; 
• Acute pain in the left testicle, arising suddenly, for no apparent reason (injury, contusion); 
• Sore left testicle, with increased pain that passes to the entire scrotum; 
• The pain is accompanied by increased body temperature, vomiting; 
• Trauma to the scrotum, accompanied by pain that does not subside within half an hour or an hour.

If the left testicle is anxious and sore, this may indicate such diseases or household, easily remediable causes: 

1. Left-sided varicose veins of the spermatic cord; 
2. Inflammatory process of infectious etiology, affecting the left side of the scrotum; 
3. Inflammatory process of infectious etiology, affecting the left appendage; 
4. Cyst of the left appendage; 
5. tumors are usually benign; 
6. The habit of wearing an uncomfortable, cramped underwear, squeezing the left side of the scrotum.

Most often, the left testicle hurts when it is injured, even a weak blow is a threat of testicular rupture, therefore, if the pain does not subside within an hour, you should seek medical help.

No less dangerous is torsion of the testicle, which can provoke squeezing of the vas deferens and dying of the testicle. Torsion occurs most often in young men, perhaps because of the developed muscles in the groin area, after 30–35 years, there is practically no torsion, which is most likely due to the gradual loss of elasticity and elasticity of the muscles.

Epididymitis is most often accompanied by very strong pain and a significant increase in the left testicle. Epididymitis usually develops against the background of bacterial, microbial infection. Pathogens - gonococci, chlamydia, affecting the urethra. The process of inflammation in the early stages is hidden, not manifested, so it develops without difficulty and affects the surrounding areas, including the organs of the scrotum. The appendages rarely inflame symmetrically, as a rule, one of them is affected. The pain manifests itself in the acute stage, which is also characterized by an increase in temperature to 39-40 degrees, a strong burning sensation during urination.

Sore left testicle because of orchitis is extremely rare, as mumps (parotitis) most often occurs in children before the onset of puberty, when the disease is relatively easy. Even in the case of an adult male mumps disease, orchitis affects only one testicle, while the latter remains healthy and produces sperm production in a normal manner.

A much more disturbing symptom may be pain in the left testicle with varicocele, when the disease passes into the third stage and is accompanied by multiple lesions of the veins (clusters). As a rule, varicocele affects the left side of the scrotum due to the nature of the venous outflow. The danger of left-sided varicocele is that blood stops flowing to the left testicle, and it gradually begins to atrophy. Moreover, the development of varicocele contributes to an increase in temperature in the region of both testicles, the production of spermatozoa is disturbed, since it requires a certain minimum - not higher than 34.5 degrees.

It hurts the left testicle and inguinal hernia, and the formation of cysts or benign tumors. Such precancerous conditions require timely diagnosis and immediate treatment, since one of the main factors for recovery in oncology is the early detection of cancer.

Diseases are diagnosed by standard urological methods - examination, a set of laboratory tests (blood, urine, prostate secretory fluid), vascular system dopplerography (scrotum area), an ultrasound examination of the abdominal cavity and x-rays are possible.

So that the pain in the testicle does not lead to sexual dysfunction, infertility or impotence, you should contact your urologist at the first alarming symptoms in order to avoid more serious problems associated with the threat not only to health, but also to life.